Unusual erythematous plaque with white scales, a case of acquired syphilis in a child and literature review

Abstract

Background Syphilis in children is uncommon with the mode of infection for this rare condition likely being congenital or acquired. While most acquired cases of syphilis in children result from sexual abuse, children can also be infected with syphilis through kissing, breastfeeding, sharing of daily necessities or pre-chewed food. Here, we report a case of acquired secondary syphilis in a child due to consumption of pre-chewed-food and provide a review of the literature on the characteristics of acquired syphilis in preschool children. Case presentation A 3-year-old girl presented with erythematous plaques and scales on her head, neck, and thighs as well as flat red papules with a moist, well circumscribed surface covered with a grayish-white film. The grandmother who cared for the girl was in the habit of pre-chewing food before giving it to the girl. The child and grandmother tested positive for RPR. The girl, who was not sexually abused, was diagnosed with acquired secondary syphilis, resulting from the transmission of pre-chewed food from her grandmother. Conclusions Our case report and literature review reveal that close contact among family members can result in the transmission of syphilis. We recommend that pre-chewing food should be discouraged by caregivers when caring for their children to avoid disease transmission.

Acquired syphilis with flat condyloma in a 3 year‐old girl: A case report

“…4 Furthermore, some easily ignored nonsexual transmission ways, such as kissing, breastfeeding, carrying, eating pre-chewed food, or sharing contaminated tableware, may be routes of sexually transmitted syphilis transmission in children. 5 The child reported herein was healthy, with no hereditary disease, no history of surgery, and no blood transfusion. Except for her grandfather, everyone in her family tested negative.…”

“…Children are especially vulnerable when family members or caregivers are infected 4 . Furthermore, some easily ignored non‐sexual transmission ways, such as kissing, breastfeeding, carrying, eating pre‐chewed food, or sharing contaminated tableware, may be routes of sexually transmitted syphilis transmission in children 5 …”

Fatores associados à transmissão vertical de sífilis em um município do Estado de São Paulo

“…6 In women smokers, an increase in the chance of vertical transmission of syphilis may occur because smoking affects the placental barrier. 7 Syphilis is considered an infection that can be controlled in Primary Health Care (PHC); therefore, early access of pregnant women to prenatal care and preventive measures against CS are necessary. According to the Ministry of Health (MH), the serological screening for syphilis should be carried out with rapid treponemal and non-treponemal tests (VDRL) in the first and third trimesters of pregnancy and before delivery or curettage.…”